Update on the Etiology, Assessment, and Management of COPD Cachexia: Considerations for the Clinician.
Update on the Etiology, Assessment, and Management of COPD Cachexia: Considerations for the Clinician.
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DOI：
10.2147/copd.s334228
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发表时间：
2022
影响因子：
2.8
通讯作者：
中科院分区：
文献类型：
--
作者：
恶病质是慢性阻塞性肺疾病（COPD）患者常见但常被忽视的肺外表现。恶病质是一种多因素综合征，其特征是体重、肌肉和脂肪严重减少，以及蛋白质分解代谢增加。慢性阻塞性肺病恶病质给患者（例如，死亡风险和疾病负担增加，运动能力和生活质量下降）和医疗保健系统（例如，住院次数、住院时间和住院费用增加）带来沉重负担。慢性阻塞性肺病恶病质的病因涉及不可改变和可改变因素的复杂相互作用（例如，吸烟、低氧血症、高碳酸血症、缺乏身体活动、能量失衡和恶化）。需要解决这些可改变的因素来预防和治疗COPD恶病质。口服营养补充结合运动训练应该是主要的多模式治疗方法。在一些（但不是全部）慢性阻塞性肺病恶病质患者中可以考虑添加药物。在可能的情况下，临床医生和研究人员应使用纵向测量（如体重减轻、肌肉质量减少）而不是横断面测量（如低体重指数或无脂质量指数）来评估COPD恶病质患者。最后，在未来的研究中，强烈建议对恶病质患者进行更详细的表型分析，以便更好地比较研究间的纳入患者，进行前瞻性纵向研究，并更多地关注恶化的影响和生物标志物在COPD恶病质中的作用。
Cachexia is a commonly observed but frequently neglected extra-pulmonary manifestation in patients with chronic obstructive pulmonary disease (COPD). Cachexia is a multifactorial syndrome characterized by severe loss of body weight, muscle, and fat, as well as increased protein catabolism. COPD cachexia places a high burden on patients (eg, increased mortality risk and disease burden, reduced exercise capacity and quality of life) and the healthcare system (eg, increased number, length, and cost of hospitalizations). The etiology of COPD cachexia involves a complex interplay of non-modifiable and modifiable factors (eg, smoking, hypoxemia, hypercapnia, physical inactivity, energy imbalance, and exacerbations). Addressing these modifiable factors is needed to prevent and treat COPD cachexia. Oral nutritional supplementation combined with exercise training should be the primary multimodal treatment approach. Adding a pharmacological agent might be considered in some, but not all, patients with COPD cachexia. Clinicians and researchers should use longitudinal measures (eg, weight loss, muscle mass loss) instead of cross-sectional measures (eg, low body mass index or fat-free mass index) where possible to evaluate patients with COPD cachexia. Lastly, in future research, more detailed phenotyping of cachectic patients to enable a better comparison of included patients between studies, prospective longitudinal studies, and more focus on the impact of exacerbations and the role of biomarkers in COPD cachexia, are highly recommended.
影响因子：
4.6
作者：
Skyba P;Ukropec J;Pobeha P;Ukropcova B;Joppa P;Kurdiova T;Stroffekova K;Brusik M;Klimes I;Tkac I;Gasperikova D;Tkacova R
通讯作者：
Tkacova R